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Osteoarthritis is a disease that affects joints in the body. It can involve any joint, but usually concerns hands and weight-bearing joints such as hips, knees, feet and spine. Cartilage is the tough elastic material that covers and protects the ends of bones. In healthy joints cartilage acts as a shock absorber when you put weight on the joint. The slippery surface of the cartilage allows the bones to move smoothly. When a joint develops osteoarthritis the cartilage gradually becomes rough and thin, and the bone underneath thickens. Osteoarthritis is classified as non-inflammatory arthritis. This suggests that there is no inflammation (swelling), but recent research shows that this is not true. Although there is usually no swelling in the early stage of the disease, as the arthritis progresses there can be inflammation. Bits of cartilage may break off and float around inside the joint. This disturbs other soft tissues inside the joint and can cause pain and swelling between bones. The result is you may have trouble moving the joint. Over time as the cartilage wears down, the bones may form bumps on their ends. These bumps are called spurs. Or, the cartilage may wear away entirely, and your bones may rub together. OA may lead to other problems such as: •
The muscles that hold the joint in place weaken because they are
not being used. How common is osteoarthritis?
What are the warning signs of osteoarthritis?
Symptoms of OA usually come on slowly, and involve the area around the joints. If you have joint pain, stiffness, or swelling for more than two weeks, see your doctor. Damage due to OA progresses slowly over time and may result in several problems. You may have pain, especially when moving a joint. Sometimes, you may hear a grating sound when the roughened cartilage on the surface of the bones rubs together. Bumps or swelling may appear, especially on the fingers and feet. A joint may feel sore and stiff, and the joint won't move as easily or as far as it once did. All these changes can make it hard to move around and to do everyday tasks, such as opening a jar or walking up stairs. Joints
Affected How does the doctor diagnose osteoarthritis? If you are experiencing persistent joint pain, visit your family doctor. Describe the pain in detail including where the pain occurs and when. The x-ray is the most useful test to confirm osteoarthritis. What causes osteoarthritis?
No one knows for sure what causes OA, although scientists are well on their way to understanding the events that lead to the breakdown of cartilage. Researchers now think that there are several factors that may increase your risk for getting OA. Key risk factors include: heredity; excess weight; injury; joint damage from another type of arthritis. Heredity The way your bones fit together may have been passed on to you from your parents. Sometimes joints don’t fit right or the cushion between your bones is not normal. You may not have problems until you are older. Excess Weight Excess weight puts extra stress on the weight-bearing joints, especially the knees and hips. The good news is losing weight, even just 10 pounds (4.5 kilograms), can help prevent osteoarthritis in your knees. Even if you have osteoarthritis in your knees, losing weight can make you feel better. Less body weight means less stress on your knees. Joint Injury If you damaged a joint and it did not heal completely, you may end up with osteoarthritis in that joint later in life. Certain occupations may predispose you to osteoarthritis. For example, people that must work in a squat position over many years may be more susceptible to osteoarthritis of the knees. Complications
of Another Type of Arthritis Osteoarthritis used to be thought of as the inevitable result of “wear and tear” on the joints. Research now shows that normal wear does not actually cause “tear.” Normal activity and exercise is good rather than bad for joints and does not cause osteoarthritis. We do not yet know the causes or the cure for osteoarthritis, but researchers in Canada and around the world are trying to learn why cartilage starts to wear away. In fact, The Arthritis Society funds many leading edge research projects that bring vital new insights and lead to new and better treatments for osteoarthritis. For example, Canadian researchers have identified some of the enzymes that damage the cartilage in osteoarthritis. Blocking these enzymes may be one way to slow down the progression of the disease. What can you do about osteoarthritis?
Establishing the correct diagnosis is very important, because something can be done to manage most forms of arthritis, and most therapies work best when started early in the disease. Your doctor may be able to diagnose OA based on your medical history and a physical examination. Sometimes, your doctor may order certain tests to help confirm the diagnosis, to determine how much joint damage exists, or to distinguish among different types of arthritis. These tests may include x-rays, blood tests or joint fluid tests. Although there is no cure for OA, a lot can be done to help manage the condition. A variety of treatments can help to lessen pain and stiffness and to make movement easier. Your active involvement in developing your prescribed treatment plan is essential.
For mild to moderate osteoarthritis doctors often recommend acetaminophen (Tylenol®, Panadol®, Exdol®, etc). Acetaminophen is a pain reliever, but does not reduce inflammation. For this reason it can usually be safely taken along with most prescription medications. However, there are daily limits of acetaminophen that you can take, so be cautious, particularly with other medications that contain acetaminophen (for example, it’s found in many cold remedies). A serious overdose of acetaminophen can cause liver damage.
Topical creams and gels that are available over-the-counter may provide temporary pain relief, but only in the areas where they are applied. These creams aren’t as effective as anti-inflammatories. Brands available include: Bengay Arthritis®, Deep Heating Rub Cream®, Minard’s Joint Relief®, Marathon Deep Heat Rub®, Menthacin®, Extra-Strength Deep Heating®, and Arthritis Patch. The majority of creams and gels use heat or cold to distract you from pain.
If acetaminophen is not doing enough to ease pain, your doctor may suggest a combination of acetaminophen and codeine. Codeine is a narcotic that affects the central nervous system, reducing sensitivity to pain. It is available in combination with acetaminophen in low doses without a prescription and in higher doses with a prescription. Some examples of codeine preparations are Tylenol 1, 2 and 3; Exdol-8, -15, -30; and Atasol-8, -15, -30. Codeine may cause constipation, which can be avoided by simple dietary changes (prune juice, bran cereals etc.) and stool softeners. Medicine: Nonsteroidal anti-inflammatory drugs (NSAIDs)
These medications can be used to help reduce pain and swelling of the joints, and decrease stiffness. However, they do not prevent further joint damage. NSAIDs reduce pain when taken at a low dose, and relieve inflammation when taken at a higher dose. You can purchase NSAIDs such as acetylsalicylic acid, also known as ASA (Aspirin®, Anacin®, etc.) and ibuprofen (Motrin®, Advil®, etc.) without a prescription. If you have more severe pain and swelling, your doctor may prescribe a different kind of NSAID such as Naprosyn®, Relafen®, Indocid®, Voltaren®, Feldene®, or Clinoril®. You may need to take NSAIDs for several weeks before they take effect completely. Common side effects of NSAIDs include stomach upset, diarrhea and abdominal pain. Elderly people, people with high blood pressure, people with kidney problems, people who have had a previous stomach ulcer, and people with congestive heart failure or those who have had a previous heart attack or stroke should talk to their doctor before taking any NSAID. NSAIDs can also interact with blood thinners such as warfarin. With the exception of small dose ASA for circulation problems, two different NSAIDs should not be taken at the same time. COX-2 inhibitors (e.g. Celebrex® and Prexige®) are a specific kind of NSAID that may be prescribed if traditional NSAIDs are hard on your stomach, or if you have an increased risk for stomach or duodenalulcers. People who have had a heart attack or stroke or experienced serious chest pain related to heart disease should not use NSAIDs or COXIBs. If you are unsure, speak to your doctor to determine if this type of treatment is right for you. To relieve pain, inflammation and minimize gastrointestinal side-effects, NSAIDs can also be delivered topically (by applying it directly to the affected area). At the time of publication, Pennsaid® is the only available prescription NSAID topical solution approved by Health Canada for OA of the knees specifically. Medicine: Corticosteroids
When osteoarthritis progresses to the point where it’s hard to get around, corticosteroid injections may be an option to reduce pain and improve mobility. Cortisone is a steroid that reduces inflammation and swelling. It is a hormone naturally produced by the body. Corticosteroids are man-made drugs that closely resemble cortisone. They are steroids that can be injected into the joints. An injection can provide almost immediate relief for a tender, swollen and inflamed joint. However, this treatment can only be used rarely, since corticosteroids can weaken the cartilage and remove the minerals from (and therefore weaken) the bone, resulting in further joint weakness. Home The Truth Claim Process About Us FAQ Contact Us Privacy Policy |